Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on thebmj.com. Although a selection of rapid responses will be included online and in print as readers' letters, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window. Letters are indexed in PubMed.
If the drug company Tremeau Pharmaceuticals does obtain permission to resurrect Vioxx (rofecoxib) for the relief of severe joint pain caused by Hamophilia, increased cardiovascular risk should be the least of its worries. Other seemingly unanticipated side effects will be of more importance including death from cerebral and gastrointestinal haemorrhage and disability from epistaxes, urinary bleeding and haemarthroses. It is possibly an outcome not even considered by the drug company that the Vioxx, used to treat the pain from haemarthroses due to Haemophilia, may actually produce haemarthroses. If some of the drug company executives are considering travelling to Britain for the wedding in May, they should know that anyone who promotes the use of a non steroidal ant-inflammatory drug as an analgesic in someone with severe Haemophilia risks being put in the Tower of London. J.L.Raven
No competing interests
04 March 2018
John L Raven
77 View Terrace. East Fremantle, WA 6158, Australia